Paper
Monday, July 7, 2008
This presentation is part of : Strategies in Chronic Care Populations
Outcome of Clinical Practice Guidelines for Exercise Utilization on Blood Pressure Reduction in Women with Hypertension
Ladawal Raknium, MNS, RN, NP1, Jom Suwanno, PhD, RN, NP2, and Roumporn Kongkamnerd, RN, NP2. (1) Department of Primary and Community Care, Ratsada Hospital, Trang, Thailand, (2) School of Nursing, Walailak University, Nakorn Si Thammarat, Thailand
Learning Objective #1: The learner will be able to identify the effectiveness of the utilization of exercise guidelines for exercise in women with hypertension.
Learning Objective #2: The learner will be able to describe the role of nurse practitoners in promoting exercise in women with hypertension.

Purpose: To evaluated the utilization of the clinical practice guidelines for exercise in women with hypertension (CPG-EWHT).

Methods: The IOWA model of evidence-based practice was used as a framework for the CPG-EWHT development. Research evidence published from 1997 to 2007 was identified using PubMed, Science Direct, and Google Scholar databases. A total of 25 research articles with substantive focused on home-based exercise, moderate exercise, and/or exercise in patients with hypertension were examined and used. This guideline consists of blood pressure assessment, contraindication for exercise, exercise education, exercise plan, and promoting patients to perform a regular, moderate intensity exercise, based on their selected modes for at least 30 minutes and three times per week. The CPG-EWHT was reviewed by a panel of five experts to ensure its safety and feasibility before implemented with 18 women with hypertension stage 1-2 (sbp 140 to 180 mmHg and/or dbp 90 to 105 mmHg).

Results: An evaluation of a six-week CPG-EWHT utilization by comparing outcomes at the 6th week with baseline revealed the reduction of means systolic blood pressure, diastolic blood pressure, pulse pressure, and pulse at rest for 21.89 mmHg (p < 0.001), 10.39 mmHg (p < 0.001), 9.15 mmHg p < 0.001), and 5 beat/min (p < 0.05), respectively. Strategies used to promote exercise in women with hypertension including the involvement of patients, their families, peer groups and nurse practitioners, exercise training, self-pulse assessment training, emotional support, monitoring by nurse practitioners, and using community resources for patients monitoring such as families members, health care volunteers, and others health care personnel.

Conclusion: The results of this study demonstrated clinical feasibility and efficiency of the utilization of the CPG-EWHT. The involvement of patients, their families, peer groups, nurse practitioners and the facilitation of communities resources are keys to success in this CPG-EWHT utilization and outcomes.